Browsing by Author "Nathan, Nshakira"

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    Determinants of Enrolment and Renewing of Community-Based Health Insurance in Households With Under-5 Children in Rural South-Western Uganda
    (International Journal of Health Policy and Management, 2019) Emmanuel, Nshakira-Rukundo; Essa, Mussa Chanie; Nathan, Nshakira; Nicolas, Gerber; Joachim, von Braun
    Abstract Background: The desire for universal health coverage in developing countries has brought attention to community-based health insurance (CBHI) schemes in developing countries. The government of Uganda is currently debating policy for the national health insurance programme, targeting the integration of existing CBHI schemes into a larger national risk pool. However, while enrolment has been largely studied in other countries, it remains a generally under-covered issue from a Ugandan perspective. Using a large CBHI scheme, this study, therefore, aims at shedding more light on the determinants of households’ decisions to enrol and renew membership in these schemes. Methods: We collected household data from 464 households in 14 villages served by a large CBHI scheme in south-western Uganda. We then estimated logistic and zero-inflated negative binomial (ZINB) regressions to understand the determinants of enrolment and renewing membership in CBHI, respectively. Results: Results revealed that household’s socioeconomic status, husband’s employment in rural casual work (odds ratio [OR]: 2.581, CI: 1.104-6.032) and knowledge of health insurance premiums (OR: 17.072, CI: 7.027-41.477) were significant predictors of enrolment. Social capital and connectivity, assessed by the number of voluntary groups a household belonged to, was also positively associated with CBHI participation (OR: 5.664, CI: 2.927-10.963). More positive perceptions on insurance (OR: 2.991, CI: 1.273-7.029), access to information were also associated with enrolment and renewing among others. Burial group size and number of burial groups in a village, were all significantly associated with increased the likelihood of renewing CBHI. Conclusion: While socioeconomic factors remain important predictors of participation in insurance, mechanisms to promote inclusion should be devised. Improving the participation of communities can enhance trust in insurance and eventual coverage. Moreover, for households already insured, access to correct information and strengthening their social network information pathways enhances their chances of renewing.
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    Factors Associated with Hand Washing Practices among Secondary School Students in Ndorwa East Constituency in Kabale District
    (Texila International Journal of Public Health, 2021) Benja, Twinomuhwezi; Topher, Byamukama; Nathan, Nshakira
    Despite the worldwide Global Hand Washing Day campaign, which targets school children as the most effective agents for behaviour change, there is limited documentation in various school settings. The purpose of the study was to assess the factors associated with hand washing practices among secondary school students in Ndorwa East Constituency in the Kabale district. The study used both quantitative and qualitative methods to collect data from a sample of 291 students from five schools. Results: Of the 291 respondents enrolled, 219(77%) washed their hands after the rest room. Factors associated with a higher likelihood of hand washing practice among secondary school students in Ndorwa East Constituency–Kabale District were being aged <18 years (aOR =8.1, 95%CI: 2.65-21.61, p<0.001), presence of water for hand washing (aOR =50.7,95%CI:11.50-309.38,p<0.001), presence of hand washing stations (aOR=7.3,95%CI:2.72-30.37, p<0.001), and cleanliness of hand washing stations (aOR=70.0,95%CI:10.44-605.6, p<0.001). The factors associated with hand washing practices were presence of water for hand washing, the presence of hand washing stations in schools, cleanliness of hand washing stations. The study suggests that the school administrators should sensitize all students to continue practicing washing hands. This would help in preventing students from diseases associated with poor hand hygiene practices.
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    Impact of community‑based health insurance on utilisation of preventive health services in rural Uganda: a propensity score matching approach
    (International Journal of Health Economics and Management, 2021) Emmanuel, Nshakira-Rukundo; Essa, Mussa Chanie; Nathan, Nshakira; Joachim, von Braun
    The effect of voluntary health insurance on preventive health has received limited research attention in developing countries, even when they suffer immensely from easily preventable illnesses. This paper surveys households in rural south-western Uganda, which are geographically serviced by a voluntary Community-based health insurance scheme, and applied propensity score matching to assess the effect of enrolment on using mosquito nets and deworming under-five children. We find that enrolment in the scheme increased the probability of using a mosquito net by 26% and deworming by 18%. We postulate that these findings are partly mediated by information diffusion and social networks, financial protection, which gives households the capacity to save and use service more, especially curative services that are delivered alongside preventive services. This paper provides more insight into the broader effects of health insurance in developing countries, beyond financial protection and utilisation of hospital-based services.
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    Safety of Drinking Water from Primary Water Sources and Implications for the General Public in Uganda
    (Hindawi, 2019-03-25) Keneth Iceland, Kasozi; Sarah, Namubiru; Roland, Kamugisha; Ejike, Daniel Eze; Fred, Ssempijja; Alfred, Omachonu Okpanachi; Hellen, Wambui Kinyi,; Jovile Kasande, Atusiimirwe; Dickson Stuart, Tayebwa; Joy, Suubo; Edgar Mario, Fernandez; Nathan, Nshakira; Andrew, Tamale
    ,ere is scarcity of information about the quality and safety of drinking water in Africa. Without such vital information, sustainable development goal number 6 which promotes availability and sustainable management of water and sanitation remains elusive especially in developing countries. ,e study aimed at determining concentrations of inorganic compounds, estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI), incremental lifetime cancer risk (ILCR), and identify safe drinking water source sources in Southwestern Uganda. Methods. ,is was an observational study in which 40 drinking water samples were collected from georeferenced boreholes, springs, open wells, bottled, and taps within Bushenyi district of Southwestern Uganda. Water samples were analyzed for copper (Cu), iron (Fe), zinc (Zn), lead (Pb), cadmium (Cd), and chromium (Cr) levels using atomic absorption spectrometry (AAS). Water safety measures (EDI, HI, and ILCR) were established for each water source and compared with local and international water permissible standards for each analyte. A spatial map was drawn using qGIS®, and analysis of quantitative data was done using MS Excel 2013 at 95% significance. Results. Heavy metals were present in the following order: 11.276 ppm> 4.4623ppm > 0.81ppm > 0.612ppm > 0.161 ppm for Fe, Zn, Pb, Cu, and Cd, respectively, while Cr was not detected. Fe was the primary water heavy metal in the order of open well > borehole > tap > spring > bottled water. ,is was followed by Zn levels in the order of tap > bottled > spring > borehole > open well. All compounds were within international water safety standards except Pb. Hence, there is need for the government of Uganda to establish water filtration systems, particularly for Pb to improve the quality of water for the general public.,eEDI was similar (P > 0.05) for water consumed from spring, bottled, and tap sources for Fe and Zn levels. Similarly, no differences were found in the EDI for children and adults (P > 0.05). Furthermore, the HI showed an absence of noncarcinogenic risk associated (HI < 1), although the ILCR was higher in adults than children (P < 0.05) due to high Cd concentrations. Conclusion. ,e current identified Fe is a major heavy metal in drinking water of Uganda, and boreholes were the major safest sources of drinking water identified in this study.